Menopause policies in the workplace are on the rise for a reason: Women who are near or at the end of their reproductive years now make up an estimated 20% of the U.S. labor force. That means a significant portion of workers are struggling with hot flashes, poor concentration, and other often debilitating effects of changing hormones.

At what cost?

While the physiological and mental health effects of menopause are well known, the economic toll that this life transition takes on women is not.

There’s more clarity now. New research from Petra Persson, a faculty fellow at the Stanford Institute for Economic Policy Research (SIEPR), is one of the first studies to measure the economics of menopause, and the results, she says, are startling. The study finds, among other takeaways, that there is a significant decline in earnings among menopausal women. Women who visit a health care provider with menopause-related symptoms are earning 10% less four years later – and it’s because they either cut back on their work hours or quit altogether.

The effects are concentrated among women without college degrees and who work manual or routine-intensive jobs. Women who work in smaller, private-sector companies are also more likely to experience the worst effects of the “menopause penalty.”

“The economic losses for working women in menopause are substantial,” says Persson, who is also an assistant professor of economics in the Stanford School of Humanities and Sciences. “For decades, social scientists have analyzed the ‘motherhood penalty,’ but until now, we haven’t known what the financial consequences are for women at the other end of the reproductive spectrum, when they enter menopause.”

The study’s findings help inform employers and government policymakers on how best to support working women as they transition into menopause. Approximately 85% of women report experiencing symptoms, which typically start between the ages of 45 and 55 and can last a decade or more. And with 60% of U.S. women between the ages of 55 and 64 in the workforce, Persson says her study underscores the need for governments and employers to help this key demographic.

“We have parental leave policies, and we have policies that support workers when their productivity dips for health reasons, so it makes sense to also have policies that help women during the menopause transition,” Persson says.

The economics case for menopause policies

Persson’s research, newly released as a working paper, sheds light on what types of policies may have economic benefits.

The study, for example, examines what happens when women are given more information about menopause and greater access to menopause-related health care, such as hormone replacement therapy (HRT) – the most effective treatment for menopausal symptoms. Persson’s study uncovers evidence to suggest that greater awareness around, and increased access to, menopause-related health care can lower the economic losses of menopause, especially for workers without college degrees.

On top of identifying a significant drop in earnings and evidence that menopause-related health care can buffer that decline, the researchers essentially find that menopause can push women into early retirement: Claims for government-funded disability insurance rise, suggesting that women who undergo the menopausal transition end up exiting the workforce permanently, through the disability insurance program.

The U.S. doesn’t have readily accessible nationwide data that would allow for examining the direct links between menopause and the outcomes that Persson and her co-authors identify, so for the study, Persson and her collaborators – Gabriella Conti of the University College London; Rita Ginja of the University of Bergen; and Barton Willage of the University of Delaware – used publicly available data from Sweden and Norway.

Persson says that, while the exact magnitudes of the effects likely can’t be extrapolated to the U.S., the findings dovetail with evidence that the menopausal transition causes economic losses in the U.S. (A Mayo Clinic study estimates menopause symptoms lead to $1.8 billion in lost work time every year in the U.S.)

The timing of Persson’s research is auspicious. In recent surveys, women report having little or no information about what to expect before and after menopause. That may be changing as more women, including celebrities like Oprah Winfrey and Naomi Watts, talk openly about their experiences with it. The issue has also taken center stage in the U.K.: The British Parliament recently held hearings on menopause and the workplace.

Persson says that there’s also rising interest in conducting more research – including a bipartisan bill introduced in Congress in 2023 calling for more federal funding of studies of menopause, perimenopause, or mid-life women’s health.

“There’s hardly any research into the economic costs of menopause, and the need to fill this void is enormous,” Persson says.

Some employers – including Fortune 500 companies – already give menopausal workers more flexible work arrangements, mental health services, and other types of support to help them navigate the transition. But they are the minority, Persson says, and much more needs to be done. Governments, for example, can enact workplace protections and help raise awareness about menopause and its symptoms.

Like employees with other types of health issues, women who are struggling with menopausal symptoms need support, Persson says. “Our study suggests policies aimed at supporting women who suffer more serious symptoms around the menopausal transition, including expanded access to menopause-related health care, may have wide-ranging economic benefits,” she says.